Loading
Form preview picture

Get Grady Epic Remote Login

Edu or fax at 404-489-3102. If the request is for IRB research purposes please forward the completed form to the Office of Research Administration Grady Memorial Hospital 3H005 via email at research gmh. edu with a copy of CITI training. After approval from Grady s Office of Compliance Office of Information Security and/or Research Administration EPIC training requirements and Log-In credentials will be provided from the Office of Information Security. Exceptions must be approved by compliance department The User requesting access is a Please select all that apply and the User will need the following access to perform his/her job select appropriately Category Access Request Grady Employees User Purpose EPIC Only Salaried Yes No Non-Grady Employee Remote-Access EPIC If not salaried the employee Current Another Position need access for On call pay paid Student/Intern Vendor/Temp Worker Nurse RN LPN NP Researcher Other please describe VPN Non-EPIC 3M ChartView/ChartScan List other positions/Depts. USER PURPOSE ACCESS WILL NOT BE GRANTED UNLESS THIS PORTION IS COMPLETED. PLEASE INDICATE NA WHERE APPLICABLE NON-RESEARCH USER PURPOSE RESEARCH USER PURPOSE Title of Study IRB Number and Expiration Date Description of duties how PHI will be used Access will be internal or external to Grady please specifically indicate location. List any and all external sources you will share PHI i.e. CDC Georgia Health other institutions If access is for recruitment please explain process PI Signature Date Internal Use Only Director/Manager or Above Must Approve As the Grady Authorizing Approver you acknowledge that the user listed above is requesting access to perform his/her job and you certify that all required forms and onboarding requirements have been completed. By signing this form you acknowledge that you have read and understand the IS-01-101 Computer Systems Acceptable Use Policy IS-01-102 Remote Access Policy. REQUEST FORM FOR EPIC AND/OR REMOTE ACCESS Please reference the IS-01-101 Computer Systems Acceptable Use Policy IS-01-102 Remote Access Policy for further guidelines regarding network access USER INFORMATION Name Job Title/Department Email Address personal emails not acceptable Telephone Institution/Vendor Last four digits of SSN if non Grady employee Access end dates are as follows Grady Employee termination of employed Non-Grady employees hired thru Grady s temporary service termination date Student/Intern End of rotation but no longer than 6 months Researcher access expires at annual renewal of study. exceptions must be approved by compliance department The User requesting access is a Please select all that apply and the User will need the following access to perform his/her job select appropriately Category Access Request Grady Employees User Purpose EPIC Only Salaried Yes No Non-Grady Employee Remote-Access EPIC If not salaried the employee Current Another Position need access for On call pay paid Student/Intern Vendor/Temp Worker Nurse RN LPN NP Researcher Other please describe VPN Non-EPIC 3M ChartView/ChartScan List other positions/Depts. Authorizing Director/Manager Signature/Title Information Security Signature/Title Research Signature/Title Compliance Signature when applicable INSTRUCTIONS Please forward completed form to the Office of Information Security via email at infosec gmh. edu or fax at 404-489-3102. If the request is for IRB research purposes please forward the completed form to the Office of Research Administration Grady Memorial Hospital 3H005 via email at research gmh. USER PURPOSE ACCESS WILL NOT BE GRANTED UNLESS THIS PORTION IS COMPLETED. PLEASE INDICATE NA WHERE APPLICABLE NON-RESEARCH USER PURPOSE RESEARCH USER PURPOSE Title of Study IRB Number and Expiration Date Description of duties how PHI will be used Access will be internal or external to Grady please specifically indicate location. List any and all external sources you will share PHI i.e. CDC Georgia Health other institutions If access is for recruitment please explain process PI Signature Date Internal Use Only Director/Manager or Above Must Approve As the Grady Authorizing Approver you acknowledge that the user listed above is requesting access to perform his/her job and you certify that all required forms and onboarding requirements have been completed. By signing this form you acknowledge that you have read and understand the IS-01-101 Computer Systems Acceptable Use Policy IS-01-102 Remote Access Policy. Authorizing Director/Manager Signature/Title Information Security Signature/Title Research Signature/Title Compliance Signature when applicable INSTRUCTIONS Please forward completed form to the Office of Information Security via email at infosec gmh.

How It Works

grady remote access rating
4.8Satisfied
57 votes

Tips on how to fill out, edit and sign Infosecgmh online

How to fill out and sign Chartview online?

Get your online template and fill it in using progressive features. Enjoy smart fillable fields and interactivity. Follow the simple instructions below:

The preparing of lawful documents can be high-priced and time-ingesting. However, with our predesigned online templates, everything gets simpler. Now, creating a Grady Epic Remote Login requires at most 5 minutes. Our state browser-based blanks and clear guidelines eradicate human-prone faults.

Comply with our easy steps to get your Grady Epic Remote Login well prepared quickly:

  1. Pick the web sample in the library.
  2. Type all required information in the necessary fillable areas. The user-friendly drag&drop interface allows you to include or relocate areas.
  3. Make sure everything is completed properly, without any typos or lacking blocks.
  4. Apply your e-signature to the PDF page.
  5. Click Done to confirm the alterations.
  6. Save the papers or print out your PDF version.
  7. Distribute instantly to the recipient.

Use the fast search and powerful cloud editor to produce an accurate Grady Epic Remote Login. Get rid of the routine and make documents on the internet!

Get form

Experience a faster way to fill out and sign forms on the web. Access the most extensive library of templates available.

Citi FAQ

Get This Form Now!

Use professional pre-built templates to fill in and sign documents online faster. Get access to thousands of forms.

Keywords relevant to Grady Epic Remote Login

  • VPN
  • cdc
  • chartscan
  • depts
  • onboarding
  • researchgmh
  • Citi
  • 3h005
  • infosecgmh
  • LPN
  • Approver
  • chartview
  • SSN
  • np
  • salaried
If you believe that this page should be taken down, please follow our DMCA take down processhere.
Ensure the security of your data and transactions

USLegal fulfills industry-leading security and compliance standards.

  • 
                            VeriSign logo picture

    VeriSign secured

    #1 Internet-trusted security seal. Ensures that a website is free of malware attacks.

  • Accredited Business

    Guarantees that a business meets BBB accreditation standards in the US and Canada.

  • 
                            TopTenReviews logo picture

    TopTen Reviews

    Highest customer reviews on one of the most highly-trusted product review platforms.